2233 SEMINOLE RD #14 - PERMIT ROOF18-0062 yL`j rlu�
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
" 13i>r i INSPECTION PHONE LINE 247-5814
ROOF NON SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: ROOF18-0062
Description: Shingle to Shingle & Mod Bit
Estimated Value: 6202
Issue Date: 6/13/2018
Expiration Date: 12/10/2018
PROPERTY ADDRESS:
Address: 2233 SEMINOLE RD UNIT 14
RE Number: 169519 0126
PROPERTY OWNER:
Name: TRAGER ALAN S
Address: 9273 RIVER SHORES LN
JACKSONVILLE, FL 32257-4912
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: Triton Roofing & Restoration LLC
Address: 480 State Rd 13 Ste 106-348
St Johns, FL 32259
Phone:
PERMIT INFORMATION:
Please see attached conditions of approval.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOU PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB
SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
NOTICE: In addition to the requirements of this permit,there may be additional restrictions
applicable to this property that may be found in the public records of this county, and there may
be additional permits required from other.governmental entities such as water management
districts, state agencies, or federal agencies.
* A notice of Commencement is only required for work exceeding an estimated value of
$2,500. For HVAC work, a Notice of Commencement is only required when HVAC work
exceeds and estimated value of$7,500.
City of Atlantic Beach APPLICATION NUMBER
Building Department (Tobe assigned.by the Building Department.)
iJ 800 Seminole Road )�
Atlantic Beach, Florida 32233-5445 ROOF O p�-
Phone(904)247-5826 • Fax(904)247-5845 ((4
E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: ZZM 3(-.�Jmino(c Department review required Yes Ao
uil8in
Applicant: —rr( R,d Planning &Zoning
c Tree Administrator
Project: J a Public Works
So Public Utilities
Qpaed c� Public.Safety
Fire Services
,Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Florida Dept. of Environmental Protection
Florida Dept. of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: E rApproved. ❑Denied. ❑Not applicable
(Circle one.) Comments:
BUILDING`S
PLANNING &ZONING Reviewed by: Date: 6-//-'p/L
TREE ADMIN. Second Review: A roved as revised.
❑ pp ❑Denied. ❑Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. ❑Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
OFFICE CP ,
04" Fli
Building Permit Applicatigg, 2018 Updated 12/8/17
City of Atlantic Beach
800 Seminole Road,Atlantic Beach,FL 32233_ _-•- —
!�
Phone:
(904)247-5826 Fax:(904)247-5845 n
Job Address: OI� SemJ 1�10te PC�/u'd t Permit-Number:
�
Legal Descriptiono?-- - �1�I,f id / RE# j&`?�l
Valuation of Work(Replacement Cost)$� ✓��'YHeated/Cooled SF 106 Non-Heated/Cooled 1067
• Class of Work(Circle one): New Additio Alteratio Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s) (Circle one): - ommerci Residential
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No N/A
• Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal
Describe in detail the type of work to be performed:W-Lo IrFshllov
moi still / Oh m� rco
If ISO
Florida Product Approval#9J93_5& 5 for multiple products uA prodpct approval form
Pro ert Owner Information ,.ate, C�01'Y Mcd-111"111 }—�(j��( � i G
Name: < %(�-f,�� -'Address: S li"_hh ��
City �1 1 L (.�] State (_ Zip �J Phone
EIII
-Mail rl 61-77D rnzV 16K-
Owner or ent(Ifrert, Power of Attorney orWency Letter Required)
Contractor Information ,_�,G
Name of Compan �(X,�-r5 �W'� lifyin Agent: t
Address 'U. City ns State R Zip 1109
Office Phone q 40 N. 2 Job Site/Contact Number
State Certification/Registration# f E-Mail Vf L'--COtn
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation ' UA f\,
Exempt/Insurer/Lease Employees/Expiration Date
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws regulationg
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING,SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS,TANKS, and AIR CONDITIONERS,etc. NOTICE: In.addition to the requirements of this
permit,there may be additional restrictions applicable to this property that may be found in the public records of this county,and
there may be additional permits required from other governmental entities such as water management districts,state agencies,or
federal agencies.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORD G YOUR N ICE OF COMMENCEMENT.
%A
(Signature of Owner r Ag t) (Signature of Contractor)
(including contractor)
nd r � ffir e- - e e this •da of Si and sworn to(or ffirm b f re m�thi ay of
by 1 �L�VJ�b .�-
Al
ISS J NES [(Sign tur 'ofTo
PjProdou'ced
rsally Known O =� = MY COMMISSION#GG092596 [� y i+f'�YP _ AAISP rsonall Known :,�. °° �,, COR4M gg ON�fVES Identifica o EXPIRES April 10,2021 [ ]Produced Identific t%+�Oyr MY -
Type of Identification: Type of Identification .�
n f 0,2029125961
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